Youth Homelessness, Disability and Institutionalization: Reflecting on My Experiences as a Homeless Youth with Disabilities this National Runaway Prevention Month
Content notes: sexual abuse, violence, trauma, institutionalization, forced treatment, self harm
On any given night, approximately 41,000 unaccompanied youth between the ages of 13 and 25 navigate homelessness alone. These youth make up a significant fraction of the 4.2 million young people who have no permanent housing. 79% of these youth report surviving multiple instances of childhood abuse. 21-42% report surviving sexual abuse. To survive, many unaccompanied youth engage in survival sex, sleep with friends or strangers, in cars, shelters, or on the streets. Many of them are LGBTQ+, parenting or pregnant. Many have disabilities: 69% of homeless youth indicate struggling with their mental health, and many struggle with their physical health due to poverty and lack of access to healthcare, or die due violence or suicide.
I know the trauma of being an unaccompanied homeless youth with a disability because I was one of them. At 18 years old I became homeless after I fled my family home due to sexual, physical, and emotional abuse. Following my high school graduation, I packed my bags into a friend’s car and fled to a former teacher’s house who knew of my situation. That first night homeless, she invited me to sleep inside in a spare bedroom, but severe asthma triggered by allergies to her cat and dog meant I was eventually sleeping outside on a blow-up mattress on her porch. Unable to stay because of increasing difficulty with my breathing, I couch surfed for the next several days between the beds and floors of friends and strangers until I found refuge in a local youth shelter.
My experiences with homelessness as a teenager were intricately related to my disability. Disability was the mechanism through which my family chose to abuse me, starting when I was nine years old and accused of being a “psychotic freak” for having night terrors. It was the mechanism through which I was othered from my siblings and shamed for preferring to curl up with my notebook rather than “be social.” At 13 years old, my unexplained physical symptoms became the reason for a medical hospitalization and subsequent psychiatric institutionalization. In the psychiatric institution, I experienced repeated sexual abuse at the hands of staff member. Later, because my parents refused to believe the trauma I had endured, self-harm became my only way to cope. The nights I spent screaming at my parents to stop hurting me, to get their hands off of me, were evidence of my being “crazy.” My father’s intrusions into my bedroom, to monitor and watch me, when I had no clothes on, and asked him to go away, justified sexual abuse in the name of what he called looking out for my personal “safety.”
At 14, my subsequent refusal to talk to my mother and father for their multiple violations of my body and trust became the justification for ripping me away from home to an abusive residential facility in New Hampshire. I spent the next 3 years in the state in a boarding school where I was subject to forced psychiatric treatment. My extended time uprooted from home, in an unsupportive and isolated environment, meant that I lost all connection to almost everyone in my community who knew me. It meant that when I ran away, I had few safe places to go; I became homeless.
Homeless Youth Face Challenges to Health and Accessing Healthcare
Throughout my childhood, years of forced treatment, institutionalizations, partial and intensive outpatient programs for mental health disorders cast me as disabled, even though I never saw myself that way. In fact, I actively resisted the notion that anything was “wrong” with me as a way to survive. I was given many diagnoses: anorexia, depression, social anxiety. Psychiatrists and family called me many names: angry, defiant, stubborn, psychotic, “messed up,” a “freak.” These names never reflected the reality of my experiences. Instead, these names were placed upon me to avoid placing culpability on those who harmed me, refusing to recognize I was living with PTSD from being abused and traumatized.
While many studies document race, ethnicity, and LGBTQ+ status among homeless youth, there are shockingly few (if any) that explicitly ask youth whether or not they consider themselves to be disabled. One of the largest surveys yet on youth homelessness, the Voices of Youth Count survey by Chapin Hall at the University of Chicago documents the percentage of homeless youth by race, LGBTQ+, pregnant or parenting status, but fails to explicitly document disability.
However, despite the lack of documentation of disability as an explicit identity category among homeless youth, a 2019 survey documents that over half as many disabled people live in poverty in comparison to non-disabled people. Approximately 45% of the general homeless population lives with a psychiatric disorder in comparison to 20.6% of the general adult population. 48% of homeless youth meet the criteria for a mental health diagnosis, and youth experiencing homelessness are over four times more likely than youth with stable housing to attempt suicide.
In terms of physical health, homeless youth are exposed to high levels of stress proceeding and during their time unstably housed that predispose them to numerous health issues. On the streets, homeless youth often continue to experience abuse and violence. Street youth are 11 times more likely to die than the general population. Crowded and unsafe living conditions mean they often acquire infectious diseases. Additionally, lack of access to mental and physical healthcare only compounds the health problems experienced by homeless youth, causing illnesses to worsen as they go untreated. When youth finally are able to access healthcare, the pervasive but stigmatizing beliefs that medical providers commonly hold about homeless youth, such as that they are inherently “delinquent,” can prevent youth from seeking further healthcare due to the fear of being retraumatized.
My Story Is One of Many of these Statistics
These statistics are sobering. I know the truth of them well because I experienced many of these things: a foot infection that I acquired from a shelter floor after a toilet exploded with sewage water, severe asthma from sleeping at my teacher’s house, and later, from being unable to wash my cat-hair covered clothes. When I left my home, I had no birth certificate, social security card, or insurance card. Lack of access to these important documents, and lack of understanding about how the healthcare system worked, or how in the world I would pay for it, meant foregoing care seemed a far better alternative than risking the bill and the shame I’d be subject to by seeing the doctor.
I avoided seeking healthcare even when I was so fatigued I could hardly crouch over the bathroom toilet. I avoided healthcare even when I was so weak and dizzy, my vision blackened every time I stood up from the floor. I avoided healthcare even when I collapsed on the stairs at work from exhaustion. When my body could not take it anymore, I found myself with cardiac arrhythmias in the emergency room. In the onslaught of diagnoses that followed, navigating drastic shifts in my health and the healthcare system completely alone, I found myself standing many nights outside by a frozen lake a footstep away from suicide.
Trauma at the Root of Youth Homelessness
The issues I faced as a homeless, disabled youth linger with me to this day. My inability to access help at the times I needed it most drove a deep wedge between me and my trust in systems. Most importantly, however, as I struggled to figure out these systems for myself, my sense of always doing the wrong thing lodged in me a deep sense of self blame, and I lost the ability to trust myself. Despite my challenges, I know my story is one of privilege in comparison to many other homeless youth. I am on track to have soon completed a college education. I am white. While fleeing my family home catapulted me into poverty, I grew up with economic privilege.
At the same time, labeling me as disabled as a child allowed me to be shuttled through a network of profoundly broken systems. At their best, these systems failed to protect me from an abusive home environment. At their worst, these systems weaponized my trauma by using mental health diagnoses to label me as the problem and perpetrate further abuse.
Today, I have the perspective of knowing that my experiences as a disabled, runaway youth are part of a larger collection of stories of homeless youth who have experienced the harms of institutionalization. Youth in congregate care facilities like the ones I was sent to as a child, are at a higher risk of becoming homeless and running away.
As a result, it’s imperative that policymakers, healthcare professionals, and homeless services systems be aware of these issues faced by disabled youth, so they do not merely push traumatized youth through the same abusive systems in an attempt to “fix” them. This awareness can help make our homeless services systems better at responding to youth who experience mental and physical health challenges by providing them with the support, care, and freedom from harm that we all deserve.
Now, four years after fleeing my home, I finally have the right to seek out and forge my own community. In February of 2021, I joined a group of formerly homeless youth and policy makers in Dane County, Wisconsin, where I am now working to build new programs to address youth homelessness. This summer, I also became part of the National Runaway Safeline’s youth advisory board, an organization that served a critical role in keeping me off of the streets as a teen. The work I have been doing with these organizations on both a local and national level has been healing. The ability to have a voice, a say in the kinds of systems that I want to see built to best serve struggling youth still feels radical to me, since I grew up believing I had no chance to be heard.
In the future I am looking forward to making sure that all kinds of transitional and emergency shelter options for youth are as accessible as possible, and that the systems built to address youth homelessness, and the people in these systems, are not ignoring disability or trauma as a critical intersection.
If I could say anything to my younger self, I wish I could tell her that what I went through as a child was not something I deserved. The ways I was treated were reflective of the failures of ableist systems, and despite my labeling as the problem, what happened to me was not my fault. While the work that I have been doing with these local and national organizations has not been easy, learning to rid myself of this shame that still stands as such a foundational pillar of my identity has been the hardest work of all.
Rachel Litchman (Rachel DL) is a queer, disabled artist, writer, and board member with Disability Pride Madison. As a formerly homeless youth and survivor of child sexual abuse and institutionalization, her creative work and advocacy is grounded in the intersections between art, activism, trauma, disability, interpersonal and institutionalized forms of violence. She currently serves on the Youth Advisory Board at the National Runaway Safeline and works with the Homeless Services Consortium of Dane County as a member of the Youth Action Board. You can find her on twitter @wordcalculator and stay updated on her current projects at racheldl.com.
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